This invention involves a chambers drainage system and in particular the handling, collection and storage of fluids issuing from a transurethral catheter device inserted in a patient after a transurethral resection procedure or a bladder tumor removal to provide continuous bladder irrigation.
After the increasingly common prostate operation and other operations, it is necessary to employ continuous bladder irrigation for a number of hours up to a couple of days after the operation. The transurethral "three-way" catheter insertion after a resection is a common procedure and a number of companies supply the equipment for insertion, inflation to retain the catheter, and connection to a collection bag, typically a four liter flexible plastic film bag, all called a "Foley" apparatus. After the operation, it is necessary to continue bladder irrigation until the fluids run clear, that is without any blood present. In the early stages of irrigation, immediately after the operation, there is substantial blood in the fluid which, over a period of time, continues to lighten in intensity until the fluid is clear. The fluid collected may be up to about three liters per hour. Immediately after the operation it is necessary that a nurse check, measure the flow, and empty the four liter urinary drainage bag about every quarter hour. If this emptying procedure is missed, there is a back up of fluids causing pressure on the prostate fossa resulting in bladder distention and bladder spasms. This frequently requires manual irrigation and increases the possibility of infection. In some cases, the transurethral apparatus has to be removed and a new one inserted causing trauma to the prostate fossa with increased bleeding, spasms and clots. In order to avoid the possibility of back up, the supliers of the urinary drainage bag have included an antireflux valve to prevent back flow to the patient when the bag fills. This has long since been determined unsatisfactory as there is substantial blood clotting in the antireflux valve clogging the flow and requiring reinsertion of a new apparatus. This particularly occurs in the early stages after the operation, when a substantial amount of blood and small clots quickly restrict the flow and cause immediate failure of the system at a stage when the patient is particularly vulnerable.
The doctors have recognized that this is an unsatisfactory situation and for a period of more than ten years have employed the system illustrated in FIG. 1. As illustrated in FIG. 1, the transurethral catheter apparatus 10 used in the procedure empties through tube 12 into standard urinary drainage bag 14. Most TURP devices include an antireflux valve in the fluid flow line of tube 12. Bag 14 will hold about four liters and is equipped with exit drainage tube 18 supplied with closure clamp 16. In order to reduce spillage, when the open system is used, tube 18 is attached with adhesive tape to the top edge of open bucket with closure valve 16 wide open. As noted above, any antireflux valve 20 present in tube 12 has been made inoperable to obtain as free a flow as possible. Attempts to construct a lid to cover the bucket and still allow the tube to be held securely while maintaining an air tight system were unsuccessful. This open system has the advantage of essentially eliminating the possibility of a backup and failure of the drainage system. It has the additional advantage that the amount of saline solution used in the continuous bladder irrigation may be increased with minimal concern for the volume of fluids used that would too quickly fill up urinary drainage bag 14. However, other problems and complications arise from the use of this open system. Using the prior art device with the open collection container, every minor spill convinces the patient that it is an overflow causing substantial emotional upset. With a free spout, no matter what the connection means to the open bucket, it is virtually impossible to avoid sudden movement of the spout dislodging it and causing it to drop to the floor. When fluids are spilled, it is impossible to measure the amounts of fluid increasing the risk that the patient may be retaining fluids caused by a clot. The open container which contains urine emits a rank odor and the stench increases as the fluid is collected. Further, there is almost always a residue in the bottom of the bucket which makes cleaning difficult. The open container is unsightly to the patient and family members visiting the patient. In fact, the visitors walking down the hallway are nauseated by the display. In addition, the constant draining sound into the bucket over a period of hours causes anguish to the patient as compared to the closed system where the stream cannot be heard. Of particular concern is that the open drainage system increases the chance of infection from bacteria entering the open system to a fresh postoperative patient. Finally, no matter what precautions are taken, there is a substantial risk of spillage from the bucket causing a wet floor and intense housekeeping problems. Rugs are not practical and a tile floor after any spillage presents a high risk of a slip and fall.
Despite this procedure being utilized for over a decade, no answer has been provided and none of the devices described in the prior art satisfy these needs nor attain the objects described hereinbelow.